Eileen C. Comia, M.D.
35 Jolley Drive Suite 102
Bloomfield CT 06002
Tel (860)242-2200
Fax (860)242-2212
info@advbiomedtx.com
mHBOT IC 2019
pg. 1 of 2
MILD HYPERBARIC OXYGEN THERAPY INFORMED CONSENT
Mild Hyperbaric Oxygen Therapy (mHBOT) is the use of oxygen at higher than normal atmospheric pressure as a
treatment. It is the method used to increase the amount of oxygen supplied to the body by increasing both the
atmospheric pressure and the concentration of oxygen. The increased pressure allows the oxygen gas to dissolve
more easily into the surrounding liquids, such as blood plasma and cerebrospinal fluids. The increased oxygenation
allows for many health benefits, such as cell growth and regeneration, detoxification, immune support, new capillary
growth, and improved neurological functioning.
SIDE EFFECTS of mild HBOT include:
Otic Barotrauma: This is a condition of injury to the eardrum, and is unlikely to occur in mHBOT. However,
severe ear discomfort can be caused if you cannot equalize the pressure in your ears. As the chamber is
pressurized, you must equalize the pressure in your ears to acclimatize the pressure changes. This is done
by “popping” your ears, either by yawning or swallowing. A more effective method is to hold your nose,
close your mouth, and blow. Continue to do this each time you feel pressure build-up in your ears.
If your ears do not acclimate normally (by the “popping”), you will experience discomfort in your ear
canals. IT IS IMPORTANT THAT YOU COMMUNICATE ANY DISCOMFORT IMMEDIATELY TO
THE ATTENDANT. The Attendant will adjust the pressure to alleviate the discomfort. If unable to equalize
the pressure in your ears, the session will have to be discontinued and a visit to your physician must be
completed before another session.
Pulmonary Hyperexpansion: This condition is rare under mHBOT. Holding your breath during
decompression must be avoided as it could lead to expansion of the air in your lungs and damage to the
lung tissues. In the highly unlikely event of an unexpected rapid decompression, it is critical that you exhale
immediately.
Die-Off Reaction: Mild HBOT may assist the body to detoxify digestive flora. An individual may
experience some discomfort in as little as 1-36 hours after the session. Symptoms may include: flu-like
symptoms, loss of appetite, stomach-ache, constipation, diarrhea, headache, behavioral issues. This is a
natural process and continuing the sessions may be of benefit to more rapidly accomplish a positive result.
If symptoms persist, individual must consult a physician for evaluation.
Insulin-Dependent Diabetes: Insulin dependency may result in a blood sugar drop while in the chamber. It
is critical that you immediately communicate to the staff if you experience or anticipate an episode. The
session will be terminated. You are required to take your blood sugar reading prior to your session (if <150,
you must snack prior to session) and again after your session (if<150, you must snack prior to leaving).
Other Side-Effects: headache or nausea, drowsiness, hyperactivity, dizziness, claustrophobia, vision-blur.
CONTRAINDICATIONS TO mHBOT:
acute asthmatic attack
high fever
seizure disorder
optic neuritis
Eileen C. Comia, M.D.
35 Jolley Drive Suite 102
Bloomfield CT 06002
Tel (860)242-2200
Fax (860)242-2212
info@advbiomedtx.com
mHBOT IC 2019
pg. 2 of 2
pneumothorax
emphysema
ear infection or blocked ear canals
sinus or upper respiratory infection
aneurysm
glaucoma
pregnancy
severe heart or lung disease
congenital spherocytosis
currently taking any of these medications: Cisplatinum, Disulphiram, or Doxorubicin.
Hyperbaric Oxygen Therapy is considered off-label treatment for certain conditions. These conditions include
Autism, Traumatic Brain Injury, stroke, Multiple Sclerosis, Chronic Fatigue Syndrome, Fibromyalgia, chronic viral
infections, Chronic Lyme, wound-healing, Diabetes, seizures, and headaches. Although it has been reported to be
beneficial for a wide range of conditions, it is not meant as a cure for any condition or disease, and no therapeutic
outcomes are guaranteed.
Acknowledging the above, I (Patient Name) __________________________________ (Date of Birth) __________
give consent to Advance Biomedical Treatment Center to administer mild Hyperbaric Oxygen Therapy to me. I
assume full liability for any adverse effects that may result from the treatment and will not hold responsible Dr.
Eileen C. Comia, Advance Biomedical Treatment Center, LLC, or any of the center’s staff for any complications
that may arise as a result of the treatment in the mild Hyperbaric Oxygen chamber.
By signing below, I have read, understood, and agree with the information presented in this consent form, have had
ample opportunities to raise concerns or ask questions, and give my permission to proceed with the mild hyperbaric
oxygen treatment.
_______________________________________ ____________________
Signature of Patient Date
If a minor, both parents must sign and date below.
If parents are divorced, please provide proof of legal child custody.
__________________________________________ _____________________
Signature of Father Date
______________________________________________ _______________________
Signature of Mother Date